摘要
目的探讨3.0T多体素氢质子磁共振波谱(1H-MRS)在评价胶质瘤术前病理分级及肿瘤浸润范围中的应用价值。方法脑胶质瘤患者60例,其中低级胶质瘤28例,高级胶质瘤32例;所有患者在术前行3.0T1H-MRS检查,检测肿瘤、瘤周区域、正常脑组织胆碱复合物(Cho)/肌酸(Cr)、N-乙酰-L-天门冬氨酸复合物(NAA)/Cr、NAA/Cho的比值。结果与正常脑组织比较,胶质瘤组织总体Cho/Cr比值升高,NAA/Cr、NAA/Cho比值下降(P<0.05);低、高级别胶质瘤组织的Cho/Cr比值也高于对侧正常脑组织,NAA/Cho及NAA/Cr低于对侧正常脑组织(P<0.05)。高级胶质瘤组织Cho/Cr比值高于低级胶质瘤,NAA/Cho比值低于低级胶质瘤(P<0.05);脑胶质瘤瘤组织Cho/Cr与病理级别呈正相关(P<0.05),NAA/Cho与病理级别呈负相关(P<0.05)。与对侧正常脑组织比较,低级胶质瘤肿瘤周围区域的Cho/Cr比值升高,NAA/Cho及NAA/Cr比值降低(P<0.05),高级胶质瘤肿瘤周围区域的Cho/Cr比值升高,NAA/Cho比值降低(P<0.05)。结论 3.0T多体素1H-MRS能反映胶质瘤细胞的生化物质代谢情况,可在一定程度上评价胶质瘤病理级别及肿瘤浸润范围,从而可提高脑胶质瘤术前诊断的准确性。
Objective To explore the application value of 3.0T multivoxel 1H magnetic resonance spectroscopy（1H-MRS） for the evaluation of preoperative pathological grading and invasion extent of brain glioma. Methods Sixty patients with brain glioma included 28 with low-grade brain glioma and 32 with high-grade brain glioma. All patients underwent 3.0T 1H-MRS examination before operation. The ratios of choline（ Cho）/creatine （Cr）, N-Aeetyl-L-aspartic acid （NAA）/Cr and NAA/Cho were measured in tumor tissue, peritumoral tissue and normal brain tissue. Results Compared to the normal brain tissue, the ratio of Cho/Cr increased and the ratios of NAA/Cr and NAA/Cho decreased in the gliomas tissue （P 〈 0.05 ） ;the ratio of Cho/Cr increased while the ratios of NAA/Cho and NAA/Cr decreased in the low-grade glioma and high-grade glioma tissue（ P 〈 0.05 ）. The ratio of Cho/Cr was higher and the ratio of NAA/Cho was lower in the high-grade glioma tissue compared to the low-grade glioma tissue （ P 〈 0.05 ）. The pathological grading positively correlated with the ratio of Cho/Cr in the glioma tissue （ P 〈 0.05 ）, and negatively correlated with the ratio of NAA/Cho （ P 〈 0.05 ）. Compared to the contralateral normal brain tissue, the ratio of Cho/Cr increased while the ratios of NAA/Cho and NAA./Cr decreased in the low-grade glioma peritumoral tissue（ P 〈0.05 ） , and the ratio of Cho/Cr increased while the ratio of NAA/Cho decreased in the high-grade glioma peritumoral tissue （ P 〈 0.05 ）. Conclusion 3.0T multivoxel 1H-MRS can reflect the metabolic condition of biochemical substance in glioma cells, and can evaluate the pathological grading and invasion extent of glioma to a certain extent, thus can improve the preoperative diagnostic accuracy of brain glioma.
出处
《广西医学》
CAS
2016年第9期1252-1255,共4页
Guangxi Medical Journal
